الفهرس 
R ESPIRATORY D ISTRESS S YNDROMEOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Background. There are limited data that compares Heated, humidified, high-flow nasal cannula (HHFNC) with nasal continuous positive airway pressure (nCPAP) as regard the efficacy & hemodynamic changes when used as an initial treatment in preterm infants with respiratory distress syndrome (RDS).
Method. A prospective study conducted aiming to evaluate the effectiveness & hemodynamic changes of HHFNC compared to nCPAP for the initial treatment of preterm infants with RDS. Preterms between 28 & 35 weeks of gestational age were randomized to HHFNC or nCPAP. Primary outcome was the incidence of treatment failure (defined as need for upgrading mechanical ventilation).
Results. Eighty-seven infants were analyzed. Ten of 47 infants randomized to HHFNC showed treatment failure (10/47, 21.3%) compared to 10 of 40 infants using nCPAP (10/40, 25%)(P > 0.05). Of these 87 infants, 46 were subjected to pulsed Doppler echocardiography, cerebral Doppler & pre-prandial mesenteric Doppler at the time of weaning. This was done while on & 1 hour after being off either HHFNC or nCPAP according to the allocated group. Both groups significantly decreased Superior mesenteric artery(SMA) flow (ml/sec)(36.4 ±15.4 vs.45.1 ± 21.2)&(33.3 ±28.2 vs. 44.4 ± 31.5) respectively with no significant mean difference between the 2 groups. Both groups didn’t show significant influence on anterior cerebral artery resistive index(RI), superior vena caval(SVC) flow, right ventricular output & left ventricular output(LVO) .With significant mean difference between HHHFNC & nCPAP groups in SVC flow (ml/kg/min) (+8.8 ±24.1 vs. -1.3± 9.8)(P = .015) & LVO (ml/kg/min)(+20.1 ± 49.6 vs. -10.3 ± 40.5)(P = .002).
Conclusion. There was no difference between the HHFNC & nCPAP in terms of respiratory & clinical outcomes, yet although they both decrease the SMA flow they did not have effect on cerebral blood flow. Also, they both didn’t have significant effect on systemic & pulmonary venous return.